Download (MDMA), Amphetamine, and LSD

HUMAN PSYCHOPHARMACOLOGY, VOL.
12, 501±504 (1997)
Ecstasy (MDMA), Amphetamine, and LSD:
Comparative Mood Pro®les in Recreational
Polydrug Users
A. C. PARROTT and M. STUART
Department of Psychology, University of East London, London E15 4LZ, UK
Twenty-one recreational polydrug users (age range: 17±34 years), were recruited into the study using the `snowball'
technique (Solowij et al., 1992). All had used MDMA (3,4-methylenedioxymethamphetamine, or `Ecstasy'), LSD
(lysergic acid diethylamide), and amphetamine, on di€erent occasions. They completed modi®ed Pro®le of Mood
States Questionnaires, to indicate their typical feeling states while on each drug. With three of the POMS factors,
MDMA was intermediate between LSD and amphetamine, with feelings of energy, con®dence and clearheadedness,
highest under amphetamine, lowest on LSD, and intermediate after Ecstasy. However in other respects MDMA's
mood pro®le was more unique, with signi®cantly higher feelings of elation, agreeableness and composure, than the
other two drugs. # 1997 John Wiley & Sons, Ltd.
Hum. Psychopharmacol. Clin. Exp. 12; 501±504, 1997.
No. of Figures: 1. No. of Tables: 1. No. of References: 22.
KEY WORDS
Ð Ecstasy; 3,4-methylenedioxymethamphetamine; MDMA; amphetamine, LSD; mood; POMS
INTRODUCTION
Methylenedioxymethamphetamine (3,4 MDMA)
is a synthetic amphetamine derivative, with a broad
spectrum of neurochemical e€ects. It is an indirect
serotonergic agonist, but also displays binding
anity for dopaminergic and other neurotransmitter receptors (Solowij, 1993; McDowell and
Kleber, 1994). While its dopaminergic agonist
actions are similar to those of amphetamine, its
serotonergic e€ects are closer to LSD. In behavioural terms, MDMA also displays similarities to
both amphetamine and LSD. Its sympathomimetic
and alerting e€ects are like those of amphetamine,
whereas its propensity for intensifying sensory
experience make it closer to LSD (McDowell and
Kleber, 1994). Some authorities have therefore
categorized 3,4-methylenedioxymethamphetamine
as an hallucinogenic amphetamine, whereas others
Correspondence to: A. C. Parrott, Department of Psychology, University of East London, London E15 4LZ, UK.
Tel: 0181 5907722 ext. 4505. Fax: 0181 8493697.
CCC 0885±6222/97/050501±04$17.50
# 1997 John Wiley & Sons, Ltd.
have suggested that it is more unique, and should
be placed within its own putative class (Nichols,
1986; Solowij et al., 1992). However there is a
paucity of empirical data on the psychopharmacological changes generated by MDMA, particularly
in relation to other drugs of abuse. The aim of
this study was therefore to investigate the comparative mood pro®les for MDMA, amphetamine
and LSD, as described by recreational polydrug
users.
MATERIALS AND METHODS
Subjects
Twenty-one unpaid subjects were obtained using
the `snowball' technique, where a small group of
known drug users spread word of the study
amongst friends and acquaintances (Solowij et al.,
1992; Davison and Parrott, 1997). All had used
amphetamine, MDMA, and LSD on di€erent
occasions. Their ages ranged from 17±34 years.
502
M. STUART AND A. C. PARROTT
Pro®le of Mood States Questionnaire (POMS)
This comprised a list of 72 mood adjectives,
grouped into six bipolar mood factors (Lorr and
McNair, 1980). The response format was modi®ed
to assess feeling state changes while on-drug
(Parrott, 1996). The instructions were as follows:
`Below are some words which describe feelings and
moods. Please tick one box for each word,
indicating how you most feel ON or OFF Ecstasy.
If you feel the SAME while on or o€ Ecstasy,
please tick the SAME box'. For example:
Most like this when ON-ECSTASY
SAME on-and-o€ Ecstasy
Most like this when OFF-ECSTASY
Each response was scored: 0, 1, or 2. With 12
adjectives per mood subscale, a score of 12
indicated no mood change on-drug, and therefore
represented baseline. The overall range of possible
scores for each bipolar scale was 0±24. Three
POMS questionnaires were completed, one for
each drug type. Subjects were instructed that their
responses for each questionnaire, should be based
upon their personal experience with each type of
drug. Anonymity and con®dentiality were assured.
RESULTS
The ANOVA drug factor was highly signi®cant for
all six POMS mood factors (all comparisons
p < 0001†). Duncan's multiple comparison tests
were performed for each pair of drug conditions,
and for each drug compared to baseline (Table 1).
Amphetamine signi®cantly a€ected three mood
factors, with increased feelings of energy, elation,
and con®dence (Figure 1). MDMA a€ected four
mood factors, with signi®cantly higher feelings of
energy, elation, agreeableness, and con®dence.
LSD led to signi®cantly higher feelings of energy
and elation, together with mental confusion,
uncertainty, and anxiety (Figure 1). The MDMA
Figure 1. Pro®le of Mood States, as recalled by recreational
polydrug users on MDMA, amphetamine, and LSD
mood scores were intermediate between amphetamine and LSD on three POMS factors: energetic/
tired, con®dent/unsure, and clearheaded/confused
(Figure 1). While on the other three POMS factors,
MDMA was not intermediate between amphetamine and LSD. Feelings of elation, agreeableness,
and emotional composure, were all signi®cantly
higher under MDMA than amphetamine or LSD
(all comparisons p < 001; Table 1).
DISCUSSION
The mood pro®le for 3,4-methylenedioxymethamphetamine (MDMA), was of increased elation,
Table 1. Duncan multiple comparison tests between drug conditions
POMS Mood State
Energetic±tired
Con®dent±uncertain
Clearheaded±confused
Elated±depressed
Agreeable±hostile
Composed±anxious
AMP/BASE MDMA/BASE LSD/BASE
p < 001
p < 001
n.s.
p < 001
n.s.
n.s.
p < 001
p < 001
n.s.
p < 001
p < 001
n.s.
p < 005
p < 005
p < 001
p < 001
n.s.
p < 001
MDMA/AMP MDMA/LSD
n.s.
n.s.
p < 001
p < 001
p < 001
p < 001
p < 001
p < 001
p < 005
p < 001
p < 001
p < 001
AMP/LSD
p < 001
p < 001
p < 001
n.s.
n.s.
p < 005
AMP, amphetamine; MDMA, 3,4-methylenedioxymethamphetamine (Ecstasy); LSD, lysergic acid diethylamide; BASE, baseline
(drug free).
HUMAN PSYCHOPHARMACOLOGY, VOL.
12, 501±504 (1997)
# 1997 John Wiley & Sons, Ltd.
RECREATIONAL POLYDRUG USE
agreeableness, energeticness and con®dence
(Figure 1). This was similar to previous reports.
Solowij et al. (1992) noted increased feelings of
energy, activation, euphoria, and con®dence, in
Australian MDMA users. Peroutka et al. (1988)
noted feelings of happiness, euphoria, alertness
and enhanced sensuality, in American college
students. Davison and Parrott (1997) documented
a pro®le of increased elation, agreeableness,
energeticness and mental confusion, in British
Ecstasy users. The above studies also described
marked physiological changes, with increased heart
rate, sweating and dehydration. These can easily
lead to medical emergencies, particularly in the hot
and crowded conditions of raves and dances. The
confused person may dehydrate through hyperthermia, or overcompensate and drink too much
water, thus lethally diluting their plasma electrolytes (Maxwell et al., 1994). The mood-elevating
e€ects of MDMA are therefore not free from
serious medical risks (Dowling et al., 1987; Henry
et al., 1992; Lee, 1994; Maxwell et al., 1994; Series
et al., 1994; Parrott, 1995).
Amphetamine demonstrated both alerting and
euphoriant e€ects (Figure 1), following its agonist
actions upon the reticular formation, and dopaminergic reward systems (Ashton, 1987). Most
previous LSD research has focused upon its
perceptual and cognitive e€ects, and its mood
pro®le has rarely been studied. The current LSD
data showed a mixture of bene®cial and detrimental mood changes, with increased energy and
elation, combined with feelings of uncertainty,
confusion and anxiety (Figure 1). In comparative terms, MDMA was intermediate between
amphetamine and LSD on three POMS factors:
energeticness, con®dence, and clearheadedness.
Whereas on the other three POMS factors,
MDMA produced signi®cantly higher scores than
both amphetamine and LSD (Figure 1; Table 1).
Overall therefore, while the alerting e€ects of
MDMA are broadly intermediate between amphetamine and LSD, its euphoriant properties seem
more unique (Nichols, 1986; Liester et al., 1992;
Solowij et al., 1992; Davison and Parrott, 1997).
It should be emphasized that subjects were asked
to describe how then typically felt on each type of
drug; yet all three drugs can generate unpleasant
experiences. Solowij et al. (1992, p. 1169) reported
that 28 per cent of their sample had su€ered
an: `Acute bad reaction to MDMA such as
paranoia, panic, loss of reality, loss of control,
anxiety, and hallucinations'. Davison and Parrott
# 1997 John Wiley & Sons, Ltd.
503
(1997) similarly noted that 25 per cent of
their subjects had experienced at least one bad
MDMA trip, due to: vomiting, paranoia, fear,
panic, feeling immobile, confused thought, or
thoughts of death (one subject now avoids all illicit
drugs, following a particularly distressing MDMA
experience). Prolonged psychiatric after-e€ects of
MDMA have also been described (Lee, 1994;
Maxwell et al., 1994; Series et al., 1994). Bad trips
are a common occupational hazard of LSD,
while amphetamine/cocaine abusers are renowned
for their paranoia, and propensity for physical
violence (Angrist. 1987).
Unpleasant mood states also occur on drug
withdrawal, during neurochemical depletion. The
after-e€ects of an amphetamine trip include feelings of fatigue, irritability, lassitude and depression. Similarly, MDMA trips are followed
by feelings of lethargy, depression, irritability,
insomnia, and paranoia, during serotonergic and
dopaminergic depletion (Solowij et al., 1992;
McDowell and Kleber, 1994). The mood changes
after an LSD trip include lassitude and nervousness, together with cognitive and perceptual ¯ashbacks. The long-term neurochemical e€ects of
repeated drug use are also a matter of concern.
Cognitive performance de®cits have been demonstrated in regular MDMA users (Krystal et al.,
1992; Parrott, 1997; Parrott et al., unpublished
data), and the serotonergic depletion which accompanies regular MDMA use, has worrying implications for the future health of young drug users
(Ricaurte and McCann, 1992; Solowij, 1993;
McDowell and Kleber, 1994;
This study su€ered from various methodological
limitations. The data were based upon retrospective
recall, so that selective memory biases may have
a€ected subjects' reports. There was no control
over what drugs had been taken (composition,
purity, or strength), nor the environmental conditions (Zinberg, 1984). Despite these problems, the
overall consistency of the current ®ndings, and
similarity to those described elsewhere (Peroutka
et al., 1988; Liester et al., 1992; Solowij et al., 1992),
provides support for their general construct
validity (Parrott, 1991). Nevertheless, placebocontrolled MDMA trials would answer a number
of crucial questions, if they were ethically sanctioned. Dose±response e€ects, time course and
recovery pro®les, acute and chronic tolerance,
inter-subject variation, expectancy, and the in¯uence of environmental factors, could all be usefully
studied.
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12, 501±504 (1997)
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M. STUART AND A. C. PARROTT
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